Tips for Insurance Reimbursement

TIPS FOR SEEKING REIMBURSEMENT FOR NEUROPSYCHOLOGICAL TESTING:

Even though I am not in-network with any insurance companies, it does not mean I cannot see you and that you cannot be reimbursed (at least partially) for my services. Many insurance plans provide some coverage for providers who are not in-network (some reimburse up to 80%). Below I offer some tips that may assist you in talking with your insurance provider. (Please note that I cannot guarantee reimbursement. This is between you and your provider.)

1) Call your insurance company’s Behavioral Health representative, and ask them whether they provide reimbursement for “OUT OF NETWORK”“NEUROPSYCHOLOGICAL TESTING.” If so, ask them the specific amount or percentage (and if there is a deductible).

2) If they ask you the “CPT CODE” for this procedure, tell them the code is “96118”. This is the medical procedure code designated for Neuropsychological Testing. Yes, your insurance provider will expect you (the patient) to know this. (!)

3) Confirm whether or not they require “PRIOR AUTHORIZATION” or a “PROVIDER REFERRAL.” Some insurance companies will not reimburse any out-of-network providers/procedures unless your Primary Care Provider (PCP) requests the service first. Neuropsychological testing is an important procedure because it will result in a clarified diagnosis that will best inform your medical provider (i.e., psychiatrist) whether medication may be warranted and, if so, it will assist them in making a well-informed decision about what kinds of medication are appropriate. If you want to be reimbursed, be sure to get your insurance company's approval before we begin. This way, when you submit your invoice after the evaluation is complete, you will not be told that you never got their permission (which will result in a denied claim).

4) They will likely ask you for my license number, NPI number and address:

My license # is: 015307 (New York State)

My NPI # is: 1760543441

My address: 114 East 90th Street, Suite #1A, NY NY 10128

I hope this information is helpful to you. It is important to me that you are able to receive as much reimbursement as possible for this very important evaluation.

michael fraser and TherapySites expressly disclaim all warranties and responsibilities of any kind, whether express or implied, for the accuracy or reliability of the content of any information contained in this site, and for the suitability, results, effectiveness or fitness for any particular purpose of the content. You are solely responsible for your use or reliance on such information and any foreseeable or unforeseeable consequences arising out of such use or reliance. In no event will michael fraser or TherapySites be liable for any damages resulting from the use of or inability to use, the content, whether based on warranty, contract, tort or other legal theory, and whether or not michael fraser or TherapySites is advised of the possibility of such damages. In no event will michael fraser's and TherapySites's aggregate liability exceed U.S. $100.